HomeMy WebLinkAboutOCDSB 516 Student Action Plan (Elementary)Appendix D to PR 515 SCO
OCDSB 517 School Operations (2019)
OCDSB 516 STUDENT ACTION PLAN (ELEMENTARY GRADES 7, 8)
(References: P.026.SCO and PR.515.SCO)
Once completed, this form becomes confidential. A copy of this document is also placed in the
OSR for the same time period established for all other related suspension documentation.
A. Student Information
Full Name
DOB
OEN
B. Parents/Guardians Information
Parent/Guardian 1 Parent/Guardian 2
Name
Address
Phone
number
Email
C. Activity Details
The student is suspended ( ) expelled ( )
Reason for suspension/expulsion
Date of suspension/expulsion
D. Learner Profile
Please Provide the Following if Applicable
[ ] Most recent Report Card/Progress Report
[ ] Individual Education Plan (IEP)
[ ] Individual STEP Assessment
[ ] Safety Plan
[ ] Other
OCDSB 516 School Operations (2019)
E. Academic Component
Please identify the course/work assignments that the student should work on during their time
in the program.
F. Non – Academic Profile
To be completed in consultation with District multi-disciplinary team staff for students
suspended eleven (11) or more days or who are expelled. Please note that for students
expelled from all the schools of the District, the satisfactory completion of the non -academic
component will be used to determine when the expulsion will end and the student may return
to a regular program.
Goal
Support/Resources
Available Success Indicator (s)
Other professionals Involved in supporting the non -academic component:
Name Role Contact
G. Planning Meeting
Name
Chair
Participants
OCDSB 516 School Operations (2019)
Primary School Contact
Signature of Principal
Date
Signature of Parent/Guardian
Date
The personal information on this form is collected under the authority of the Education Act (RSO.1990
c.E.2) ss. 58.5, 265 and 266 as amended, and in accordance with the Municipal Freedom of
Information and Protection of Privacy Act (RSO.1990 c.M56), as amended. It will be used for student
and education related purposes, such as administration, communication, and data reporting. In addition
the information may be used or disclosed to comply with legislation, for compelling circumstances
affecting health and safety or discipline, as required in circumstances related to law enforcement
matters, and with third parties in accordance with establishes service agreements or in accordance with
any other Act. Questions or concerns should be directed to the school principal or the District's
Freedom of Information Coordinator, Ottawa-Carleton District School Board, 133 Greenbank Road,
Ottawa, Ontario K2H 6L3, Telephone 613-596-8211, ext. 8607.
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